Patient Encounter Part 2 Medical History Physical Exam and Diagnostic Tests PMH Asthma controlled

FH: Father living with diabetes mellitus, type 2 (controlled) and chronic obstructive pulmonary disease; mother living with hypertension (controlled)

SH: Second year pharmacy student. Works as a pharmacy intern at a local hospital

Allergies: Penicillin (patient states she was admitted to a hospital at the age of 7 years with hives and throat swelling after receiving amoxicillin)

Meds: Albuterol (salbutamol) inhaler as needed

ROS: (+) dysuria, urinary frequency; (-) fever, nausea, vomiting, flank pain PE:

VS: BP 122/64 mm Hg, P 62 bpm, RR 16 per minute, afebrile CV: RRR, normal S1, S2; normal findings

Abd: Soft, nontender, nondistended; (+) bowel sounds, no hepatosplenomegaly, heme (-) stool

Labs: Within normal limits; (-) pregnancy test

Given this additional information, what is your assessment of the patient's condition? Identify your treatment goals for the patient.

What nonpharmacologic pharmacologic alternatives are available for the patient? General Approach to Treatment

Antimicrobial therapy is the cornerstone of treatment in UTIs. Antimicrobials should ideally be well tolerated, narrow in antimicrobial spectrum, lend itself to patient compliance (low total number of doses), have adequate concentrations at the site of the infection, and have good oral bioavailability. Table 79-2 reviews oral and IV antibiotics frequently used to treat UTIs with comments on their use, and Table 79-3 reviews frequency, duration, and doses of oral antibiotics used commonly for outpatient treatment of UTIs.

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